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Clinicopathological Profile and Treatment Outcomes of Sinonasal Small Cell Neuroendocrine Carcinoma: A Rare Case Series

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Abstract

Sinonasal small cell neuroendocrine carcinoma is a rare tumour in the head and neck region. Patients become symptomatic as the disease progresses to advanced stages. They are at risk for recurrence and distant metastasis following treatment. Early diagnosis and treatment have shown to improve the disease prognosis. This is a retrospective analysis of sinonasal small cell neuroendocrine carcinomas that underwent treatment based on institutional protocol. Data was collected from medical records of the patients and analyzed using descriptive statistics. Cell morphology on electron microscopy and immunohistochemistry played a significant role in differentiating small cell neuroendocrine carcinoma from other neuroendocrine tumours. 75% of cases presented in an advanced stage of malignancy. None of the patients had distant metastasis at initial presentation. Equal proportion of cases underwent surgery followed by adjuvant radiation (33.3%) and concurrent chemoradiation (33.3%). 25% of patients had recurrence of disease. The 2-year overall survival rate was 78.8%. Disease-free survival for cases that underwent surgery followed by radiation was higher than that of chemoradiation or radiation alone arms. There has been an improvement in treatment outcomes of sinonasal small cell neuroendocrine carcinoma which is best explained by paradigm shift in multimodality management towards surgery followed by adjuvant treatment.

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Abbreviations

SCNEC:

Small cell neuroendocrine carcinoma

SNUC:

Sinonasal neuroendocrine undifferentiated carcinoma

DFS:

Disease free survival

OAS:

Overall survival

DSS:

Disease specific survival

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Acknowledgements

Our sincere gratitude to all patients, faculty members, fellows, post-graduate trainees and staff of the Departments of Head & Neck Surgery, Surgical Oncology, Pathology, Radiation Oncology and Medical Records, Regional Cancer Centre, Thiruvananthapuram who cooperated with us in completion of this study.

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Authors and Affiliations

  1. Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Elizabeth Mathew Iype, Sandeep Suresh, Shirish Patil & Shaji Thomas

  2. Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Anila K.R. & Sindhu Nair

  3. Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Malu Rafi

Authors
  1. Elizabeth Mathew Iype
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  2. Sandeep Suresh
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  3. Shirish Patil
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  7. Shaji Thomas
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Correspondence to Sandeep Suresh.

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Ethical approval was obtained from the Institutional Ethics Committee.

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Iype, E.M., Suresh, S., Patil, S. et al. Clinicopathological Profile and Treatment Outcomes of Sinonasal Small Cell Neuroendocrine Carcinoma: A Rare Case Series. Indian J Otolaryngol Head Neck Surg 71 (Suppl 3), 2214–2218 (2019). https://doi.org/10.1007/s12070-019-01667-1

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